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The concept of psychological mindedness is used to describe a person's ability to perceive relationships among thoughts, emotions and actions, in order to learn the meanings and causes of his or her behaviour. Psychological mindedness is clinically important because it influences the efficacy of psychotherapy. Individuals who have difficulty symbolizing and resolving emotional conflict, and verbally expressing their emotions, are considered to lack psychological mindedness, a deficit also known as alexithymia. In this study, Nadia Ferrara examines cultural differences in styles of emotional expression and psychological mindedness by comparing two groups: Euro-Canadians, and Cree Amerindians – who are often stereotyped as taciturn and less verbally expressive. She investigates the ethnographic, historical and cultural context of the Cree people, as well as their style of communication, narratives, beliefs, and views of imagery, dreams and art. Working with the Cree group, she has discovered that art therapy provides an effective channel of emotional communication for many of them: thus, inability to discuss feelings, imagery or fantasy may not indicate an underlying psychological deficit. Ferrara argues that some cultures predispose individuals to use non-verbal modes of emotional expression, but that psychiatry does not take into consideration in clinical assessment. This, of course, can lead to misdiagnosis. Her fascinating and thought-provoking study challenges the assumption that the constructs and practices of psychiatry can always be appropriate cross-culturally.